Repetitive Transcranial Magnetic Stimulation

Written by Mara Taylor
| Published on December 13, 2013Medically Reviewed by George Krucik, MD, MBA
on December 13, 2013

Repetitive
transcranial magnetic stimulation (rTMS) is a form of brain stimulation therapy.
It uses magnetic pulses instead of electricity to activate parts of the brain.
Developed in 1985, rTMS has been studied as a possible therapy for depression.
It may also be applied for other neurological and psychological disorders, such
as Parkinson’s disease, stroke, tinnitus, obsessive-compulsive disorder, and
dystonia. In 2008, the U.S. Food and Drug Association approved rTMS as a
treatment for patients with major depression who do not respond to
antidepressants.

How rTMS Works

A doctor
places an electromagnetic coil against a patient’s forehead near the area of
the brain that regulates mood. The coil then passes magnetic pulses to a
targeted part of the brain. This induces an electrical current in specific
nerve cells. The procedure contrasts to electroconvulsive therapy (ECT), in
which an electrical current is delivered throughout the brain.

A typical rTMS
session usually lasts a little under an hour. A doctor delivers magnetic
stimulation at set intervals throughout the session. Depending on a patient’s condition
and the discretion of the doctor, the length, intensity, and time between
intervals may vary to produce the best results.

Repetitive
transcranial magnetic stimulation is a fairly new form of treatment. Doctors
are still studying its effects. But, scientists believe the magnetic
stimulation can reset brain wave frequencies to normal levels and improve
symptoms of depression.

Who It’s For

Repetitive
transcranial magnetic stimulation is usually recommended only after medication
and psychotherapies fail to work. Doctors suggest at least one round of
prescription antidepressants in combination with psychotherapy before exploring
the possibility of rTMS.

The most
qualified candidates for rTMS are depression patients who have not had success
with other methods. Also, in these patients, other brain stimulation therapies
might be too dangerous. Patients who are not in good enough health to undergo a
procedure such as ECT might be better candidates for rTMS.

Patients with
any sort of implanted medical device, such as a pacemaker, are typically not
eligible for the treatment. If you have a history of epilepsy, you also may
need to explore other options. As is the case with most brain stimulation
therapies, pregnant women, children, and elderly people might not be candidates
for rTMS.

Possible Side Effects or Complications

Clinical
trials on the effectiveness of rTMS have shown mixed results. Because rTMS is
one of the newer forms of brain stimulation therapy, long-term studies are not
available yet. Although rTMS is considered to be the least invasive kind of
brain stimulation therapy, it still poses risks. Possible side effects include:

a
slight tapping or knocking sensation as the magnetic pulses are passed
through bone

headache

scalp
irritation or discomfort

twitching
in facial or neck muscles

seizure

hearing
loss

nausea

vision
problems

mania

Serious side
effects such as seizure and hearing loss are rare. But, it’s best to talk to
your doctor if you’re concerned about the risks of rTMS.

What the Experts Say

In a 2008 study published in Experimental
Neurology, Dr. Mark George and Dr. Frank Padberg note that rTMS may be a
promising option for patients with depression.

“Repetitive TMS
treatment might have a therapeutic beneﬁt not only for major depression, but
also for depression associated with neurological disorders, such as Parkinson's
disease (PD) and stroke.”

George and
Padberg also say that rTMS may be a better option than other forms of brain
stimulation therapy. This is because it has a lower rate of adverse effects. And,
the treatment does not negatively interact with medications commonly taken for
depression.

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